Real-time, volumetric imaging of radiation dose delivery deep into the liver during cancer treatment

Zhang, Wei; Oraiqat, Ibrahim; Litzenberg, Dale W.; Chang, Kai-Wei; Hadley, Scott; Sunbul, Noora Ba; Matuszak, Martha M.; Tichacek, Christopher J.; Moros, Eduardo G.; Carson, Paul L.; Cuneo, Kyle C.; Wang, Xueding; Naqa, Issam El

doi:10.1038/s41587-022-01593-8

Cited by 20 publications

(26 citation statements)

References 45 publications

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“…In our previous study, simulations were completed to account for these effects 50 . For patient study feasibility, X. Wang and I. El Naqa's group demonstrated that with LINAC x‐ray beam, relative dose distribution field can be reconstructed 51 . However, they pointed out that their methods mostly image the edges of the radiation field, and better algorithms are needed to get quantitative dose information.…”

Section: Discussionmentioning

confidence: 99%

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Towards quantitative in vivo dosimetry using x‐ray acoustic computed tomography

et al. 2023

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BackgroundRadiation dosimetry is essential for radiation therapy (RT) to ensure that radiation dose is accurately delivered to the tumor. Despite its wide use in clinical intervention, the delivered radiation dose can only be planned and verified via simulation. This makes precision radiotherapy challenging while in‐line verification of the delivered dose is still absent in the clinic. X‐ray‐induced acoustic computed tomography (XACT) has recently been proposed as an imaging tool for in vivo dosimetry.PurposeMost of the XACT studies focus on localizing the radiation beam. However, it has not been studied for its potential for quantitative dosimetry. The aim of this study was to investigate the feasibility of using XACT for quantitative in vivo dose reconstruction during radiotherapy.MethodsVarian Eclipse system was used to generate simulated uniform and wedged 3D radiation field with a size of 4 cm 4 cm. In order to use XACT for quantitative dosimetry measurements, we have deconvoluted the effects of both the x‐ray pulse shape and the finite frequency response of the ultrasound detector. We developed a model‐based image reconstruction algorithm to quantify radiation dose in vivo using XACT imaging, and universal back‐projection (UBP) reconstruction is used as comparison. The reconstructed dose was calibrated before comparing it to the percent depth dose (PDD) profile. Structural similarity index matrix (SSIM) and root mean squared error (RMSE) are used for numeric evaluation. Experimental signals were acquired from 4 cm 4 cm radiation field created by Linear Accelerator (LINAC) at depths of 6, 8, and 10 cm beneath the water surface. The acquired signals were processed before reconstruction to achieve accurate results.ResultsApplying model‐based reconstruction algorithm with non‐negative constraints successfully reconstructed accurate radiation dose in 3D simulation study. The reconstructed dose matches well with the PDD profile after calibration in experiments. The SSIMs between the model‐based reconstructions and initial doses are over 85%, and the RMSEs of model‐based reconstructions are eight times lower than the UBP reconstructions. We have also shown that XACT images can be displayed as pseudo‐color maps of acoustic intensity, which correspond to different radiation doses in the clinic.ConclusionOur results show that the XACT imaging by model‐based reconstruction algorithm is considerably more accurate than the dose reconstructed by UBP algorithm. With proper calibration, XACT is potentially applicable to the clinic for quantitative in vivo dosimetry across a wide range of radiation modalities. In addition, XACT's capability of real‐time, volumetric dose imaging seems well‐suited for the emerging field of ultrahigh dose rate “FLASH” radiotherapy.

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Section: Discussionmentioning

confidence: 99%

“…Instead, implementing a transducer array can improve the SNR. In Zhang et al., 51 they achieved high SNR signals in liver with a planar transducer array that has center frequency of 0.35 MHz. Hence, we will be able to reconstruct dose more accurately in deeper fields by improving SNR.…”

Section: Discussionmentioning

confidence: 99%

Towards quantitative in vivo dosimetry using x‐ray acoustic computed tomography

et al. 2023

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“…A clinically ready iRAI imaging system was adapted from our previous commercial US platform based iRAI and US dual-modality imaging system 14,17 , shown in Fig. 1A.…”

Section: Methodsmentioning

confidence: 99%

The development of ionizing radiation acoustic imaging (iRAI) for mapping the dose deep in the patient body during radiation therapy

Zhang,

Litzenberg,

Huang

et al. 2024

Photons Plus Ultrasound: Imaging and Sensing 2024

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Ionizing radiation acoustic imaging (iRAI) provides the potential to map the radiation dose during radiotherapy in real time. Described here is the development of iRAI volumetric imaging system in mapping the three-dimensional (3D) radiation dose deposition of clinical radiotherapy treatment plan with patient receiving radiation to liver tumor. The real-time visualizations of radiation dose delivered have been archived in patients with liver tumor under a clinical linear accelerator. This proof-of-concept study demonstrated the potential of iRAI to map the dose distribution in deep body during radiotherapy, potentially leading to personalized radiotherapy with optimal efficacy and safety.

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“…In continuous and repeatable cancer treatment modalities including PDT and hyperthermia, monitoring cancer progression concurrently with treatment is important to evaluate and improve treatment effectiveness. This is typically done through regular imaging studies 24,25 , such as computed tomography (CT) scans, or bioluminescence. These tests help to determine the size and spread of cancer and can help guide decisions about treatment options and adjustments.…”

Section: Introductionmentioning

confidence: 99%

Fully implantable and battery-free wireless optoelectronic system for modulable cancer therapy and real-time monitoring

Kim

Min

Kim

et al. 2023

Preprint

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Photodynamic therapy (PDT) is attracting attention as a next-generation cancer treatment that can selectively destroy malignant tissues, exhibit fewer side effects, and lack pain during treatments. Although implantable PDT systems have recently been developed to resolve the issues of bulky and expensive conventional PDT systems and to implement continuous and repetitive treatment, they only focus on providing the function of cancer termination. In cancer treatment procedures, monitoring and treatment of cancer must be done simultaneously. Existing implantable PDT systems, however, are not able to perform multiple functions simultaneously, such as modulating light intensity, measuring, and transmitting tumor-related data. Furthermore, not only current PDT systems, but also most other existing portable cancer treating/monitoring systems provide only a single limited function, resulting in the complexity of cancer treatment. Here, we introduce a flexible and fully implantable wireless optoelectronic system capable of continuous and effective cancer treatment by fusing PDT and hyperthermia and enables tumor size monitoring in real-time. This system exploits micro inorganic light-emitting diodes (µ-LED) that emit light with a wavelength of 624 nm, designed not to affect surrounding normal tissues by utilizing a fully programmable light intensity of µ-LED and precisely monitoring the tumor size by Si phototransistor during a long-term implantation (2–3 weeks). The superiority of simultaneous cancer treatment and tumor size monitoring capabilities of our system operated by wireless power and data transmissions with a cell phone was confirmed through in vitro experiments, ray-tracing simulation results, and a tumor xenograft mouse model in vivo. This all-in-one single system for cancer treatment offers unprecedented opportunities to not only enable effective treatment of tumors located deep in the tissue but also enable precise and continuous monitoring of tumor size in real time.

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Real-time, volumetric imaging of radiation dose delivery deep into the liver during cancer treatment

Cited by 20 publications

References 45 publications

Towards quantitative in vivo dosimetry using x‐ray acoustic computed tomography

Towards quantitative in vivo dosimetry using x‐ray acoustic computed tomography

The development of ionizing radiation acoustic imaging (iRAI) for mapping the dose deep in the patient body during radiation therapy

Fully implantable and battery-free wireless optoelectronic system for modulable cancer therapy and real-time monitoring

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